An ultra-low-profile 0.85 mm Nano Hydro balloon to treat wire-crossable balloon-uncrossable lesions: A useful tool in CTO armamentarium

Balloon uncrossable lesions are commonly encountered during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). A sequential strategy and planning are required to tackle such lesions. We present a case series of severely calcified, device uncrossable lesions where the traditional strategies failed and an ultra-low-profile (0.85 mm) balloon was crucial to successful PCI. To our best knowledge, this is the first case series describing the use of this balloon in real world.     

The effect of improvement in diabetic control on plasma and whole blood viscosity

Summary Rheological studies were made on the blood of 12 diabetic patients after a period of poor diabetic control (HbA₁ 12.6±0.7% (mean ± SD); mean home capillary blood glucose level 11.7±1.2 mmol/l), and after at least three months of improved control (HbA₁ 9.1±0.4%, p<0.01; mean home capillary blood glucose level 9.2±0.6 mmol/l). There were significant decreases in plasma fibrinogen levels (4.1±0.6 to 3.7±0.6 g/l, p <0.01), plasma viscosity (1.31±0.1 to 1.25±0.04, p<0.001), and whole blood viscosity at low (22.8±2.7 to 20.2±2.9, p<0.01) and high shear rates (3.4 ±0.2 to 3.1±0.2, p<0.01). Ten diabetics with clinically evident complications were matched with diabetics of similar age, sex, duration and current control of diabetes. There were no significant differnces in plasma or whole blood viscosities between the two groups. Hyperviscosity in diabetes seems strongly related to hyperglycaemia and to be influenced by the quality of diabetic control.     

Kinematics of 2 Reciprocating Endodontic Motors: The Difference between Actual and Set Values

Introduction

The aim of this study was to evaluate the kinematics of 2 reciprocating motors and compare it with manufacturers' declared values.

Methods

VDW Silver (VDW, Munich, Germany) and ATR Tecnika (Tecnika, Pistoia, Italy) were used in the study in 5 working modes: continuous rotation at 400 rpm on VDW Silver and ATR Tecnika and reciprocating motion on ATR Tecnika at 400 rpm and on VDW Silver in Reciproc and WaveOne mode. The polishing disk with an optical target was inserted in the contra-angle and recorded with a 1000–frames per second video camera. The direction and the amount of rotation were analyzed by computer, and the following kinematics parameters were calculated: engaging and disengaging angles, cycle rotational speeds, engaging and disengaging rotational speeds, net cycle angle, total cycle angle, and number of cycles to complete full rotation. One-way analysis of variance followed by planned pair-wise comparisons was used to compare kinematics parameters. The alpha error was set to 0.05.

Results

Analysis of variance revealed a difference between actual and set values of all 3 reciprocating modes in all kinematics parameters (P < .001). No significant difference between the actual engaging angle of Reciproc and that of the WaveOne mode was found. For reciprocating motion on the ATR Tecnika at 400 rpm, the actual engaging and disengaging angles were 8- and 9-fold greater, respectively, compared with set angles (P < .001).

Conclusions

The kinematics of reciprocating instrumentation is more complex than it seems as described only with angles and rotational speed. Actual kinematics values differ from manufacturers' declared values.